低收入和中等收入国家抑郁和焦虑的数字健康干预措施:快速范围审查。

IF 5.8 2区 医学 Q1 PSYCHIATRY
Jmir Mental Health Pub Date : 2025-08-22 DOI:10.2196/68296
Leena W Chau, Raymond W Lam, Harry Minas, Kanna Hayashi, Vu Cong Nguyen, John O'Neil
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引用次数: 0

摘要

背景:在全球精神疾病负担中占较大比例的低收入和中等收入国家(LMICs)由于先前存在的精神卫生保健系统缺陷,受到COVID-19大流行的不成比例的影响。大流行还导致通过数字精神卫生干预措施(DMHIs)提供的护理大幅增加,其中许多干预措施已从面对面的形式改编而来。因此,有必要检查它们对原始格式的忠实程度,以及关于可用性和其他挑战的问题,以及它们在中低收入国家采用的促进因素。由于大多数DMHIs是在高收入国家开发的,因此检查它们对中低收入国家环境的文化适应性也至关重要。目的:本研究的目的是对DMHIs治疗中低收入国家最常见的两种精神障碍抑郁和焦虑的现有证据进行快速范围审查。方法:根据PRISMA-ScR(系统评价和荟萃分析扩展范围评价的首选报告项目)和Tricco等人的快速评价流程进行快速范围评价。在PubMed和PsycINFO数据库中检索了2020年1月(当COVID-19被宣布为公共卫生紧急事件时)至2025年1月期间发表的记录,使用了与联络图书管理员协商制定的搜索策略。大流行加速了DMHIs的开发和应用,并利用这一时间框架收集了可能包含新应用方法的最新文献。搜索策略跨越三个领域:(1)数字健康干预,(2)抑郁或焦虑,以及(3)低收入人群。根据(1)干预类型,从最终记录中绘制数据图表;(2)保真度、可用性和文化适应性的讨论;(3)中低收入国家采用这些方法的挑战和促进因素。结果:共有80份记录被纳入最终分析,并报告了排除原因(例如,关注一般心理健康,不是DMHI,或不关注低收入国家)。确定了六个DMHI平台:(1)移动应用程序,(2)网络,(3)虚拟现实,(4)视频会议,(5)远程医疗和(6)社交媒体。不到一半的记录提到了保真度(16/ 80,20%)、可用性(29/ 80,36%)和文化适应性(31/ 80,39%)。挑战涉及技术系统、参与问题、结构性障碍以及对隐私和机密性的担忧。便利因素包括手机的广泛使用、内置的监督和培训功能以及便利性。结论:尽管DMHIs为缩小心理健康治疗差距提供了机会,但需要进一步研究和提高其保真度、可用性和文化适应性。此外,中低收入国家采用DMHIs的各种挑战,包括背景问题、结构性障碍和隐私问题,必须加以缓解,以避免进一步加剧数字鸿沟。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Digital Health Interventions for Depression and Anxiety in Low- and Middle-Income Countries: Rapid Scoping Review.

Digital Health Interventions for Depression and Anxiety in Low- and Middle-Income Countries: Rapid Scoping Review.

Background: Low- and middle-income countries (LMICs), which bear a larger proportion of the global mental illness burden, have been disproportionately impacted by the COVID-19 pandemic due to preexisting mental health care system deficiencies. The pandemic has also led to a considerable increase in care delivered through digital mental health interventions (DMHIs), many of which have been adapted from in-person formats. Thus, there is a need to examine their fidelity to the original format along with issues regarding usability and other challenges to and facilitators of their uptake in LMICs. As most DMHIs have been developed in high-income countries, examining their cultural adaptation to LMIC settings is also critical.

Objective: The purpose of this research was to conduct a rapid scoping review of the available evidence on DMHIs for depression and anxiety, two of the most common mental disorders, in LMICs.

Methods: A rapid scoping review was conducted following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) and processes for rapid reviews by Tricco et al. The PubMed and PsycINFO databases were searched for records published between January 2020 (when COVID-19 was declared a public health emergency) and January 2025 using a search strategy developed in consultation with a liaison librarian. The pandemic accelerated the development and application of DMHIs, and this time frame was used to capture the recent literature that may have incorporated new methods of application. The search strategy was developed across three domains: (1) digital health interventions, (2) depression or anxiety, and (3) LMICs. Data were charted from the final records according to (1) intervention type; (2) discussions on fidelity, usability, and cultural adaptation; and (3) challenges to and facilitators of their uptake in LMICs.

Results: A total of 80 records were included in the final analysis, with reasons for exclusion (eg, focused on mental health in general, not being a DMHI, or not focused on LMICs) reported. Six DMHI platforms were identified: (1) mobile app, (2) the web, (3) virtual reality, (4) videoconferencing, (5) telemedicine, and (6) social media. Less than half of the records referenced fidelity (16/80, 20%), usability (29/80, 36%), and cultural adaptation (31/80, 39%). Challenges pertained to the technological system, engagement issues, structural barriers, and concerns regarding privacy and confidentiality. Facilitators included widespread mobile phone use, built-in supervision and training features, and convenience.

Conclusions: Despite the opportunities that DMHIs offer for reducing the mental health treatment gap, further work examining and improving their fidelity, usability, and cultural adaptation is required. In addition, various challenges to the uptake of DMHIs in LMICs, including contextual issues, structural barriers, and privacy concerns, must be mitigated to avoid contributing further to the digital divide.

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来源期刊
Jmir Mental Health
Jmir Mental Health Medicine-Psychiatry and Mental Health
CiteScore
10.80
自引率
3.80%
发文量
104
审稿时长
16 weeks
期刊介绍: JMIR Mental Health (JMH, ISSN 2368-7959) is a PubMed-indexed, peer-reviewed sister journal of JMIR, the leading eHealth journal (Impact Factor 2016: 5.175). JMIR Mental Health focusses on digital health and Internet interventions, technologies and electronic innovations (software and hardware) for mental health, addictions, online counselling and behaviour change. This includes formative evaluation and system descriptions, theoretical papers, review papers, viewpoint/vision papers, and rigorous evaluations.
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